Main responsibilities and Opportunities:
Scrutiny of Medical Records & Cases. Provide Medical opinion for Health Insurance-Preauth & Claims.
Processing of Cashless Requests & Health Insurance Claim Documents.
Ample Knowledge of medical terminology and willingness to work in the non-clinical field.
Understanding of Policies, Terms & Conditions & Various Protocols / Guidelines regarding Health Insurance with Claims adjudication/Claims Processing.
Follow & Implement Standard Operating Procedures & Protocols
Treatment Wise Procedure Coding.
Manage volumes effectively & efficiently to maintain Turnaround time (TAT) of processing cases
Should be Versatile for Morning/Afternoon Shifts
Required Candidate Profile
Good Medical field knowledge.
Good Excellent oral and written communication, negotiation, and decision-making skills.
Good customer relationship skills and ability to work effectively in a fast-paced environment with shifting priorities.
Perks and Benefits:- One of the Best in the Industry
Employment Type: Contractual Job, Full Time & Part-time.
Role Category: Medical Professional – Non-Clinical.
Education: UG: BAMS – Any Specialization, BHMS – Any Specialization, MBBS – Any Specialization, PG: Post Graduation Not Required Doctorate: Doctorate Not Required
Key Skills:-
Claims Adjudication, Claims Processing, Health Insurance
Standard Operating Procedures, Medical Scrutiny, Procedure Coding, Medical
📌 Medical Coordinator Officer (Mumbai)
🏢 C S Creative Solutions
📍 Mumbai
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